Hábito alimentar de adultos brasileiros segundo a condição na força de trabalho / Eating behavior of Brazilian adults according to workforce position / Hábitos alimentarios de los adultos brasileños según su situación laboral

Resumo O objetivo desse artigo é avaliar o hábito alimentar da população adulta no Brasil segundo a condição na força de trabalho. Realizou-se estudo transversal com dados de 63.782 adultos (18 a 59 anos), participantes da Pesquisa Nacional de Saúde (PNS) 2019. A condição na força de trabalho - ocupado, desocupado ou fora da força - foi relacionada com marcadores de consumo alimentar saudável e não saudável. Estimaram-se razões de chance (odds ratio) ajustadas com regressão logística multinomial. Os resultados apontam que, entre os adultos brasileiros, 71,3% estavam ocupados, 6,7% desocupados e 21,9% encontravam-se fora da força de trabalho. Os ocupados apresentaram maior frequência de consumo de frutas, hortaliças e carne vermelha, e menor de feijão. O consumo de frango, bebidas de frutas, cereais, ovos, margarina e pratos prontos/semiprontos foi mais frequente para os desocupados versus ocupados, enquanto o de peixes e tubérculos foi menos frequente. Os adultos fora da força de trabalho, comparados aos ocupados, mostraram menor frequência de consumo de refrigerantes, embutidos, pães de pacote, oleaginosas, assim como do costume de substituir o almoço por lanches. Observaram-se discrepâncias na alimentação segundo a condição de trabalho, sobretudo no consumo de hortaliças, frutas, carnes e feijão, denotando a necessidade de iniciativas de promoção da alimentação adequada e saudável voltadas para a saúde do trabalhador.

Abstract Objective: To evaluate eating habits of the adult population in Brazil according to workforce status. Methods: Cross-sectional study with data from 63,782 adults (18-59 years old) participating in the National Health Interview Survey, PNS 2019. Workforce status - employed, unemployed or not part of the workforce - was related to markers of healthy and unhealthy food intake. Adjusted odds ratios were estimated with multinomial logistic regression. Results: Of Brazilian adults, 71.3% were employed, 6.7% were unemployed and 21.9% were outside the workforce. Employed adults showed a higher frequency of fruit, vegetable and red meat intake, and a lower frequency of beans consumption. The consumption of chicken, fruit drinks, cereals, eggs, margarine and ready-made/semi-ready meals was more frequent among the unemployed versus the employed, while fish and root vegetables were less frequently consumed. Adults outside the workforce, compared to the employed, showed a lower frequency of consumption of soft drinks, sausages, packaged bread, oilseeds, as well as the habit of replacing lunch for snacks. Conclusion: Discrepancies in diet were observed according to working condition, especially in the consumption of vegetables, fruits, meat, and beans, denoting the need for initiatives to promote adequate and healthy eating habits to improve workers' health.

Resumen Objetivo: Evaluar hábitos alimentarios de la población adulta según su situación laboral. Métodos: Estudio transversal con datos de 63.782 adultos brasileros (18-59 años), participantes de la Encuesta Nacional de Salud, PNS-2019. La situación en la población activa, ocupada, desocupada o fuera de ella, estaba relacionada con marcadores de ingesta de alimentos saludables y no saludables. Las odds ratio ajustadas (odds ratio) se estimaron con regresión logística multinomial. Resultados: De los adultos, 71,3% estaban ocupados, 6,7% desocupados y 21,9% fuera de la población activa. Los empleados mostraron mayor frecuencia de consumo de frutas, verduras y carne roja, y una menor de frijoles. El consumo de pollo, bebidas de frutas, cereales, huevos, margarina y platos preparados/semipreparados era más frecuente entre los desocupados frente a los ocupados, mientras que el pescado y los tubérculos eran menos frecuentes. Los adultos fuera de la fuerza de trabajo, en comparación con los empleados, mostraron menor frecuencia de consumo de refrescos, embutidos, pan envasado, semillas oleaginosas, así como el hábito de sustituir el almuerzo por bocadillos. Conclusión: Se observaron discrepancias en la alimentación según la condición de trabajo, especialmente en el consumo de hortalizas, frutas, carnes, frijol, denotando la necesidad de iniciativas de promoción de alimentación saludable dirigida a la salud de los trabajadores.

Secular trends and factors associated with overweight among Brazilian preschool children: PNSN-1989, PNDS-1996, and 2006/07 / Tendência secular e fatores associados ao excesso de peso entre pré-escolares brasileiros: PNSN-1989, PNDS-1996 e 2006/07

OBJECTIVE: to describe the secular trends in overweight among preschool children in the years 1989, 1996, and 2006, and to identify risk factors associated with this condition in 2006. METHODS: anthropometric data from three surveys (1989, 1996, and 2006) with a representative sample of the population were analyzed. Overweight was defined as the weight-for-height Z-score. The multivariable models of overweight association with risk factors were generated by Poisson regression, and the estimates were shown as prevalence ratios with their respective 95% confidence intervals (PR [95% CI]). RESULTS: throughout the 17-year period studied, the relative prevalence of overweight in preschoolers increased by 160% in Brazil, representing an increase of 9.4% per year. Based on data from the National Survey on Demography and Health of Women and Children - 2006/07, four multivariable models were created (macro-environmental, maternal, individual, and final model) assuming hierarchy among the risk factors. In the final model, only the following remained associated with overweight: regions South/Southeast (1.55 [1.17 to 2.06]), middle-class (1.35 [1.02 to 1.77]), maternal obesity (1.66 [1.22 to 2.27]), birth weight > 3.9 kg (1.87 [1.31 to 2.67]), and being an only child or having only one sibling (1.81 [1.31 to 2.49]). CONCLUSION: the prevalence of overweight among preschool children in Brazil has increased dramatically over the past 17 years, and it was higher in the 1996-2006 period. Future strategies for prevention and control of overweight in public health should focus or intensify actions in communities that are characterized by the presence of the risks identified in the present study. .

OBJETIVO: descrever a tendência secular do excesso de peso (EP) entre pré-escolares nos anos de 1989, 1996 e 2006 e identificar os fatores de risco associados a esta condição em 2006. MÉTODOS: análise dos dados de três inquéritos antropométricos (1989, 1996 e 2006) com a mostra representativa da população brasileira. O EP foi definido como o escore-Z de peso-para-altura > + 2. Os modelos multivariáveis de associação do EP com os fatores de risco foram gerados por meio da regressão de Poisson e as estimativas apresentadas como razão de prevalência com seus respectivos intervalos de confiança de 95% (RP [IC 95%]). RESULTADOS: no período de 17 anos estudado, a prevalência relativa do EP em pré-escolares aumentou em 160% no Brasil, representando incremento de 9,4% ao ano. A partir dos dados da Pesquisa Nacional de Demografia e Saúde da Mulher e da Criança-2006/07 criamos quatro modelos multivariáveis (macroambiental, materno, individual, modelo final) assumindo hierarquia entre os fatores de risco. No modelo final, permaneceram como fatores associados ao EP: as macrorregiões Sul/Sudeste (1,55 [1,17-2,06]), a classe média (1,35 [1,02-1,77]), a obesidade materna (1,66 [1,22-2,27]), o peso ao nascer > 3,9 kg (1,87 [1,31-2,67]) e ser filho único ou possuir um irmão (1,81 [1,31-2,49]). CONCLUSÃO: a prevalência de EP entre pré-escolares no Brasil aumentou drasticamente nos últimos 17 anos, sendo mais intenso no intervalo de 1996-2006. Futuras estratégias de prevenção e controle do EP em saúde pública devem considerar em seu escopo, ou intensificar suas ações, nas coletividades que se caracterizem pela presença dos riscos identificados neste trabalho. .

Secular trends and factors associated with overweight among Brazilian preschool children: PNSN-1989, PNDS-1996, and 2006/07.

OBJECTIVE: to describe the secular trends in overweight among preschool children in the years 1989, 1996, and 2006, and to identify risk factors associated with this condition in 2006. METHODS: anthropometric data from three surveys (1989, 1996, and 2006) with a representative sample of the population were analyzed. Overweight was defined as the weight-for-height Z-score. The multivariable models of overweight association with risk factors were generated by Poisson regression, and the estimates were shown as prevalence ratios with their respective 95% confidence intervals (PR [95% CI]). RESULTS: throughout the 17-year period studied, the relative prevalence of overweight in preschoolers increased by 160% in Brazil, representing an increase of 9.4% per year. Based on data from the National Survey on Demography and Health of Women and Children - 2006/07, four multivariable models were created (macro-environmental, maternal, individual, and final model) assuming hierarchy among the risk factors. In the final model, only the following remained associated with overweight: regions South/Southeast (1.55 [1.17 to 2.06]), middle-class (1.35 [1.02 to 1.77]), maternal obesity (1.66 [1.22 to 2.27]), birth weight ≥ 3.9kg (1.87 [1.31 to 2.67]), and being an only child or having only one sibling (1.81 [1.31 to 2.49]). CONCLUSION: the prevalence of overweight among preschool children in Brazil has increased dramatically over the past 17 years, and it was higher in the 1996-2006 period. Future strategies for prevention and control of overweight in public health should focus or intensify actions in communities that are characterized by the presence of the risks identified in the present study.

Trends of body composition among adolescents according to maturation stage and body mass index.

BACKGROUND: Excessive increases in percentage body fat (%BF) according to sex may pose greater risks of chronic diseases. OBJECTIVE: To evaluate trends of body composition according to sexual maturation stage and body mass index (BMI) of adolescents. METHOD: Data about weight, height, lean mass, fat mass, %BF, BMI and sexual maturation of 1345 private school students (685 girls) aged from 7 to 18 years were collected in 2001 and compared with data of 1450 students (750 girls) collected in 2010 in Campinas, Brazil. χ2-test, ANOVA and logistic regression were used for statistical analyses (p<0.05). RESULTS: Obesity prevalence increased, and number of boys and girls with normal BMI (p=0.0183 and p=0.0041) decreased. Differences in the median values of the study variables according to time point and nutritional diagnosis were not significant, except for lean mass (p=0.0484) and height (p=0.0275) in B2 (Breast stage) and %BF (p=0.0324) in G5 (Genitalia stage). CONCLUSION: Body composition did not change significantly, although overweight increased.

[Birth weight in Brazilian children under two years of age]. / Peso ao nascer de crianças brasileiras menores de dois anos.

Low birth weight is associated with increased risk of dying in the first year of life. This study was motivated by recent changes in the determination of birth weight patterns with the advent of the perinatal epidemiological transition. We analyzed data from the Brazilian National Survey of Demographic and Health of Children and Women including only children < 24 months. Prevalence of low birth weight in Brazil was 6.1%. Risk factors included female gender, residence in the South and Southeast geographic regions, low maternal education, and maternal smoking. The low birth weight profile changed, with higher prevalence in more economically developed regions, reflecting the neonatal epidemiological transition determined by changes in patterns of childbirth care and incorporation of perinatal life support technologies, in addition to the previously known biological risks associated with poverty and misinformation.

Peso ao nascer de crianças brasileiras menores de dois anos / Birth weight in Brazilian children under two years of age / Peso al nacer de niños brasileños menores de dos años

O baixo peso ao nascer tem grande relação com risco de morrer no primeiro ano de vida. Estudos mostram sua associação com problemas de desenvolvimento na infância e doenças na vida adulta. Dada a importância desse indicador, o objetivo deste estudo foi investigar os fatores sociais, demográficos, biológicos e ambientais envolvidos na sua determinação. Analisaram-se dados da Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher (PNDS-2006), incluindo apenas crianças menores de 24 meses de vida. A prevalência de baixo peso ao nascer no Brasil foi de 6,1%. Os fatores de risco identificados foram sexo feminino, residir nas macrorregiões Sul e Sudeste e ser filho de mães com baixa escolaridade ou tabagistas. Houve mudanças no perfil do baixo peso ao nascer, com maior prevalência em regiões mais desenvolvidas economicamente, refletindo a transição epidemiológica perinatal, caracterizada por mudanças nos padrões de assistência ao parto e incorporação dos avanços tecnológicos na assistência perinatal, além de fatores de risco biológicos conhecidos associados à pobreza e à desinformação.

Low birth weight is associated with increased risk of dying in the first year of life. This study was motivated by recent changes in the determination of birth weight patterns with the advent of the perinatal epidemiological transition. We analyzed data from the Brazilian National Survey of Demographic and Health of Children and Women including only children < 24 months. Prevalence of low birth weight in Brazil was 6.1%. Risk factors included female gender, residence in the South and Southeast geographic regions, low maternal education, and maternal smoking. The low birth weight profile changed, with higher prevalence in more economically developed regions, reflecting the neonatal epidemiological transition determined by changes in patterns of childbirth care and incorporation of perinatal life support technologies, in addition to the previously known biological risks associated with poverty and misinformation.

El bajo peso al nacer tiene una gran relación con el riesgo de morir en el primer año de vida. Estudios muestran su asociación con problemas de desarrollo en la infancia y enfermedades en la vida adulta. Dada la importancia de este indicador, el objetivo de este estudio fue investigar los factores sociales, demográficos, biológicos y ambientales involucrados en su determinación. Se analizaron los datos de la Investigación Nacional de Demografía y Salud del Niño y de la Mujer (PNDS-2006), incluyendo solamente niños menores de 24 meses de vida. La prevalencia de bajo peso al nacer en Brasil fue de un 6,1%. Los factores de riesgo identificados fueron sexo femenino, residir en las macrorregiones Sur y Sudeste y ser hijo de madres con baja escolaridad o tabaquistas. Hubo cambios en el perfil de bajo peso al nacer, con mayor prevalencia en regiones más desarrolladas económicamente, reflejando la transición epidemiológica perinatal, caracterizada por cambios en los padrones de asistencia al parto e incorporación de los avances tecnológicos en la asistencia perinatal, además de factores de riesgo biológicos conocidos, asociados a la pobreza y a la desinformación.

Prevalence and factors associated with overweight among Brazilian children younger than 2 years.

OBJECTIVE: To describe the prevalence of overweight, analyze its progression from 1989 to 2006 and identify factors associated with it among children younger than two years in Brazil. METHODS: Data for the Women and Children National Demography and Health Survey (PNDS 2006) were collected using questionnaires and anthropometric measurements. The study sample included 1,735 children aged 0 to 24 months (910 boys; 825 girls). Nutritional status was defined according to the weight-for-height index (W/H; WHO, 2006), and children were classified as overweight if their W/H z score was greater than +2. RESULTS: Prevalence of overweight in Brazil was 6.54%. The highest prevalence of overweight was found in the southern (10.0%) and midwestern (11.1%) regions, among families with a per capita income higher than one minimum wage (11.8%), in social classes with a greater purchasing power (9.7%), among children whose birth weight was greater than 3 kg (8.04%) and whose exclusive breastfeeding lasted less than five months (7.4%). According to a fitted multiple logistic regression model, factors associated with overweight were: birth weight ≥ 3 kg [odds ratio (OR) = 5.2, 95% confidence interval (95%CI) 2.56-10.56], per capita income ≥ 1 minimum wage (OR = 2.50, 95%CI 1.20-5.21), residence in midwestern region (OR = 2.40, 95%CI 1.01-5.72). CONCLUSIONS: The comparison of the prevalence found in the 2006 survey with the 1989 and 1996 values revealed that overweight among children younger than two years tends to decrease. The risk factors identified suggest that further actions should be conducted to prevent obesity among infants living in the midwestern region of Brazil, whose birth weight was greater than 3 kg and whose families had a per capita income higher than one minimum wage.

Prevalência e fatores associados ao excesso de peso em crianças brasileiras menores de 2 anos / Prevalence and factors associated with overweight among Brazilian children younger than 2 years

OBJETIVO: Descrever a prevalência de excesso de peso obtida na Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher de 2006, analisar sua evolução no período de 1989 a 2006 e identificar os fatores associados em crianças brasileiras menores de 2 anos. MÉTODOS: Dados da Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher de 2006. Informações obtidas por meio de questionários e mensurações antropométricas para subamostra de 1.735 crianças de 0 a 24 meses (910 meninos, 825 meninas). Excesso de peso foi definido como valor do indicador peso para altura (WHO, 2006) superior ao escore z +2. RESULTADOS: A prevalência de excesso de peso no país foi de 6,5%. Maiores prevalências foram observadas nas regiões Sul (10,0%) e Centro-Oeste (11,1%), nas famílias com renda per capita superior a um salário mínimo (11,8%), nas classes sociais de maior poder aquisitivo (9,7%), em crianças com peso ao nascer superior a 3 kg (8,04%) e com tempo de amamentação exclusiva inferior a 5 meses (7,4%). A regressão logística múltipla evidenciou como fatores associados: peso ao nascer > 3 kg [odds ratio (OR) = 5,20; intervalo de confiança de 95% (IC95%) 2,56-10,56], renda per capita > um salário mínimo (OR = 2,50; IC95% 1,20-5,21) e residir na macrorregião Centro-Oeste (OR = 2,40; IC95% 1,01-5,72). CONCLUSÕES: Comparando a prevalência de 6,5% encontrada no inquérito de 2006 com os anteriores de 1989 e 1996, evidencia-se que o excesso de peso em menores de 2 anos apresenta tendência de decréscimo. Os fatores de risco identificados apontam para a necessidade de intensificar ações de prevenção da obesidade junto aos lactentes residentes na Região Centro-Oeste, aos nascidos com mais de 3 kg e aos pertencentes a famílias com renda per capita superior a um salário mínimo.

OBJECTIVE: To describe the prevalence of overweight, analyze its progression from 1989 to 2006 and identify factors associated with it among children younger than two years in Brazil. METHODS: Data for the Women and Children National Demography and Health Survey (PNDS 2006) were collected using questionnaires and anthropometric measurements. The study sample included 1,735 children aged 0 to 24 months (910 boys; 825 girls). Nutritional status was defined according to the weight-for-height index (W/H; WHO, 2006), and children were classified as overweight if their W/H z score was greater than +2. RESULTS: Prevalence of overweight in Brazil was 6.54%. The highest prevalence of overweight was found in the southern (10.0%) and midwestern (11.1%) regions, among families with a per capita income higher than one minimum wage (11.8%), in social classes with a greater purchasing power (9.7%), among children whose birth weight was greater than 3 kg (8.04%) and whose exclusive breastfeeding lasted less than five months (7.4%). According to a fitted multiple logistic regression model, factors associated with overweight were: birth weight > 3 kg [odds ratio (OR) = 5.2, 95% confidence interval (95%CI) 2.56-10.56], per capita income > 1 minimum wage (OR = 2.50, 95%CI 1.20-5.21), residence in midwestern region (OR = 2.40, 95%CI 1.01-5.72). CONCLUSIONS: The comparison of the prevalence found in the 2006 survey with the 1989 and 1996 values revealed that overweight among children younger than two years tends to decrease. The risk factors identified suggest that further actions should be conducted to prevent obesity among infants living in the midwestern region of Brazil, whose birth weight was greater than 3 kg and whose families had a per capita income higher than one minimum wage.

[Secular trends in age at menarche in relation to body mass index]. / Tendência secular da idade da menarca avaliada em relação ao índice de massa corporal.

OBJECTIVE: To evaluate the secular trend of menarche according to body mass index (BMI). SUBJECTS AND METHODS: Six hundred and eighty five girls (7-18 years) assessed in 2001 were compared with 750 evaluated in 2010. They were grouped by BMI Z-score: (thin + normal) and (overweight + obese). Menarche was reported by status quo and age at menarche estimated by a logit model. We used the Qui-square test, Mann-Whitney test, and Logistic Regression, at a 5% significance level. RESULTS: Menarche advanced 3.24 months. There was an increase in obesity, and a decrease of the prevalence of normal girls. Menarche was anticipated by 1.44 month in the thin + normal group and by 5.76 months in the overweight + obese group. There was no interaction between the effects determined by the evaluated period and nutritional diagnosis. CONCLUSIONS: Although both the period and BMI influence the menarche, one cannot attribute this advance only to changes in the nutritional profile of the sample. Other factors that were not tested may also contribute to this finding.

Tendência secular da idade da menarca avaliada em relação ao índice de massa corporal / Secular trends in age at menarche in relation to body mass index

OBJETIVO: Avaliar a tendência secular da menarca de acordo com o índice de massa corporal (IMC). SUJEITOS E MÉTODOS: Seiscentos e oitenta e cinco meninas (7-18 anos) avaliadas em 2001 foram comparadas a 750 avaliadas em 2010. Elas foram agrupadas pelo Z-escore do IMC em: (magreza + eutrofia) e (sobrepeso + obesidade). A menarca foi relatada pelo status quo e a idade, estimada pelo logito. Foram utilizados os testes Qui-quadrado, Mann-Whitney e a Regressão logística, com significância de 5%. RESULTADOS: A menarca adiantou 3,24 meses entre 2001 e 2010. Houve aumento da obesidade e diminuição de eutróficas. O evento antecipou 1,44 mês no grupo magreza + eutrofia e 5,76 meses no sobrepeso + obesidade. Não houve interação entre os efeitos determinados pelo período avaliado e diagnóstico nutricional. CONCLUSÕES: Embora tanto o período quanto o IMC tenham influenciado a menarca, não se pode atribuir essa antecipação só à mudança do perfil nutricional da amostra. Outros fatores não testados podem estar contribuindo também para isso.

OBJECTIVE: To evaluate the secular trend of menarche according to body mass index (BMI). SUBJECTS AND METHODS: Six hundred and eighty five girls (7-18 years) assessed in 2001 were compared with 750 evaluated in 2010. They were grouped by BMI Z-score: (thin + normal) and (overweight + obese). Menarche was reported by status quo and age at menarche estimated by a logit model. We used the Qui-square test, Mann-Whitney test, and Logistic Regression, at a 5% significance level. RESULTS: Menarche advanced 3.24 months. There was an increase in obesity, and a decrease of the prevalence of normal girls. Menarche was anticipated by 1.44 month in the thin + normal group and by 5.76 months in the overweight + obese group. There was no interaction between the effects determined by the evaluated period and nutritional diagnosis. CONCLUSIONS: Although both the period and BMI influence the menarche, one cannot attribute this advance only to changes in the nutritional profile of the sample. Other factors that were not tested may also contribute to this finding.

[Historical evolution of utensils used to feed non breastfed infants]. / Evolução histórica dos utensílios empregados para alimentar lactentes não amamentados.

The objective of this article is to describe the utensils used throughout history to feed non breastfed infants. The method used was article review, reference search on the MEDLINE, LILACS and SciELO databases from 1966 to 2007 and documental analysis based on data from the internet, encyclopedias, art and history books, and museums. Utensils manufactured in a variety of materials and shapes, depending on availability, purchasing power and culture have been used since early history to feed babies who for different reasons were not breastfed. Many objects coexisted at the same time and place, others at distant sites and times. New alternatives have been accepted without evidence to prove or point toward the benefits of the change. Some of these alternatives were adopted again, even if infant mortality was high at the time in which they were used at first. In the beginning of the 20th century, bottles became conic-cylindrical. Technology brought about progress as to improve hygiene and enable contamination control. Glass gave way to plastic, and rubber nipples to silicone ones, but the bottle as we know it today is still the same of a 100 years ago.

Evolução histórica dos utensílios empregados para alimentar lactentes não amamentados / Historical evolution of utensils used to feed non breastfed infants

O objetivo desse artigo de revisão é descrever os utensílios empregados ao longo da história para alimentar lactentes não amamentados. O levantamento bibliográfico foi realizado nas bases de dados MEDLINE, LILACS e SciELO, de 1966 a 2007. Para a análise documental, foram processadas buscas na Internet, em enciclopédias, livros de arte, história e museus. Utensílios manufaturados com materiais e formas variadas, dependendo da disponibilidade, poder aquisitivo e cultura, foram empregados desde os primórdios da história para alimentar bebês que, por diferentes motivos, deixaram de ser amamentados. Muitos objetos coexistiram na mesma época e local, outros em tempos e pontos geográficos distantes. A aceitação de uma nova alternativa ocorria sem evidência que comprovasse ou apontasse para os benefícios da mudança. Alguns utensílios voltaram a ser empregados embora a mortalidade infantil fosse elevada à época em que foram utilizados. No início do século XX, as mamadeiras assumiram a forma cilíndrica cônica. A tecnologia trouxe avanços no sentido de melhorar a higienização e possibilitar o controle da contaminação. O vidro deu lugar ao plástico e os bicos de borracha, aos de silicone, mas a mamadeira, como a conhecemos hoje, é a mesma de cem anos atrás.

The objective of this article is to describe the utensils used throughout history to feed non breastfed infants. The method used was article review, reference search on the MEDLINE, LILACS and SciELO databases from 1966 to 2007 and documental analysis based on data from the internet, encyclopedias, art and history books, and museums. Utensils manufactured in a variety of materials and shapes, depending on availability, purchasing power and culture have been used since early history to feed babies who for different reasons were not breastfed. Many objects coexisted at the same time and place, others at distant sites and times. New alternatives have been accepted without evidence to prove or point toward the benefits of the change. Some of these alternatives were adopted again, even if infant mortality was high at the time in which they were used at first. In the beginning of the 20th century, bottles became conic-cylindrical. Technology brought about progress as to improve hygiene and enable contamination control. Glass gave way to plastic, and rubber nipples to silicone ones, but the bottle as we know it today is still the same of a 100 years ago.

Dobras cutâneas e bioimpedância elétrica perna-perna na avaliação da composição corporal de crianças / Skinfold thicknesses and leg-to-leg bioimpedance for the assessment of body composition in children

OBJETIVO: Comparar os componentes da composição corporal, obtidos pela bioimpedância elétrica perna-perna e pela espessura das dobras cutâneas, em crianças. MÉTODOS: A composição corporal de 1 286 escolares (703 meninas e 538 meninos) entre 7 e 9 anos foi avaliada pelas dobras triciptal e subescapular e pela bioimpedância elétrica perna-perna (TANITA TBF-300ª). Para analisar a concordância entre o percentual de gordura corporal, a massa gorda e a massa magra obtidos pelos métodos, foram utilizados o coeficiente de correlação de Pearson (r) e o modelo de Bland-Altman. RESULTADOS: A correlação (r) foi alta e significante, respectivamente nas meninas e nos meninos, para o percentual de gordura corporal (0,77 e 0,89), para a massa gorda (0,93 e 0,94) e para a massa magra (0,92 e 0,89). O modelo de Bland-Altman também mostrou haver boa concordância entre os métodos, uma vez que poucos pontos, correspondentes às diferenças entre as medidas feitas pelos métodos, estavam fora do intervalo de confiança. CONCLUSÃO: Estes resultados demonstram que a técnica de bioimpedância elétrica perna-perna é comparável à técnica das dobras cutâneas para avaliar a composição corporal de escolares em estudos populacionais. Individualmente, a ampla variabilidade observada em algumas medidas sugere que a utilização da bioimpedância elétrica perna-perna ou das dobras cutâneas deve ser associada a outros indicadores na avaliação da composição corporal.

OBJECTIVE: The objective of this study was to compare the components of body composition obtained by leg-to-leg bioimpedance and skinfold thickness measurements in children. METHODS: Triceps and subscapular skinfold thicknesses and TANITA TBF-300A leg-to-leg bioimpedance were used to determine the body composition of 1 286 schoolchildren (703 girls and 583 boys) aged 7 to 9 years. The Pearson's correlation coefficient (r) and Bland-Altman plot were used to analyze the agreement between the two methods. RESULTS: The two methods correlated strongly and significantly for girls´ and boys´ percentage of body fat (0.77 and 0.89, respectively), fat mass (0.93 and 0.94 respectively) and lean mass (0.92 and 0.89 respectively). The Bland-Altman plot also showed good agreement between the methods, since only a few points corresponding to the differences between the measurements obtained by the two methods were outside the confidence interval. CONCLUSION: These results show that both methods, triceps and subscapular skinfold thicknesses and leg-to-leg bioimpedance, can be used to asses the body composition of schoolchildren in population-based studies. Yet, the wide variability observed in some measurements suggests that either method should always be associated with other indicators to assess body composition.

Estado nutricioal de pacientes diabéticos atendidos em uma unidade básica de saúde, Campinas-SP / Nutritional status of diabetic patients assisted at a primary care unit in the city of Campinas/São Paulo-Brazil

O estudo objetivou avaliar a compisição corporal e o perfil bioquímico de indivíduos diabéticos. Participaram 105 pacientes, foram realizadas medidas antropométricas, composição corporal por bioimpedãncia elétrica e exames bioquímico, sendo que 70 por cento relataram apresentar a doença há mais de 5 anos e 43,3 por cento eram obesos (IMC=30). As mulheres apresentaram maior IMC (30,65+-4,45Kg/m2 vs 28,04+-5,21Kg/m2) e percentual de gordura corporal (38,19+-4,49 por cento vs 29,91+-4,65 por cento) em comparação aos homens. Os valores médios da glicemia, HbAac e colesterol total estvam acima dos valores de referência, em ambos os sexos. Estes resultados indicam a necessidade de capacitar e implementar intervenções no âmbito da prevenção secundária nesta população, com o objetivo de reduzir as complicações e problemas decorrentes do diabetes, com vistas a melhoria de sua qualidade de vida.

Body mass index and body composition in relation to sexual maturation.

AIM: To assess body mass index. (BMI) in relation to sexual maturation and verify how fat-free mass (FFM) and fat mass (FM) contribute to its increase. METHODS: 1,275 White adolescents (656 girls and 619 boys), aged 9 to 18 years, were evaluated according to Tanner stages. FFM and FM were calculated by triceps and subscapular skinfold measurements and leg-to-leg bioelectrical impedance. BMI-for-maturation was distributed into percentiles. Fat-free mass index (FFMI) and body fat mass index (BFMI) were calculated based on BMI 50t" ph percentile values. RESULTS: During maturation, as BMI increases, girls gain FFMI (13.3 kg/m2 at B1 and 15.8 kg/m2 at B5) and BFMI (3.7 kg/m2 at B1 and 5.7 kg/m2 at B5)--proportionally more fat-- while boys gain FFMI (14.3 kg/m2 at G1 and 17.9 kg/m2 at G5) and lose BFMI (4.8 kg/m2 at G1 and 3.2 kg/m2 at G5). CONCLUSION: These data suggest that FFMI and BFMI-for-maturation should be assessed in adolescents monitored for overweight and obesity.